Premium
Comparison of three prophylactic antibiotic regimens in clean‐contaminated head and neck surgery
Author(s) -
Rodrigo Juan P.,
Alvarez Juan C.,
Gómez Justo R.,
Suárez Carlos,
Fernández José A.,
Martínez José A.
Publication year - 1997
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/(sici)1097-0347(199705)19:3<188::aid-hed4>3.0.co;2-z
Subject(s) - medicine , cefazolin , surgery , clindamycin , gentamicin , perioperative , antibiotics , antibiotic prophylaxis , anesthesia , amoxicillin , regimen , microbiology and biotechnology , biology
Background Although appropriate perioperative antibiotic prophylaxis has significantly reduced wound infection rates in clean‐contaminated head and neck surgical procedures, controversy still remains regarding the optimal antibiotic regimen. Methods In this prospective, double‐blind clinical trial, 159 patients were randomized to receive amoxicillin‐clavulanate, clindamycin plus gentamicin, or cefazolin intravenously up to ½ hour before surgery and at 8‐hour intervals for an additional three doses. Results An overall wound infection rate of 23% was observed. Thirteen (22.8%) infections occurred in the amoxicillin‐clavulanate‐treated group, 11 (21.2%) in the clindamycin plus gentamicin‐treated group, and 13 (26%) in the cefazolin‐treated group, which was not statistically significant. Only prior medical illnesses, such as chronic obstructive pulmonary disease and diabetes mellitus, correlated with an increased wound infection rate ( p = 0.018). Conclusions Amoxicillin‐clavulanate, clindamycin plus gentamicin, and cefazolin seem to have similar efficacy when administered prophylactically in clean‐contaminated head and neck surgical procedures. © 1997 John Wiley & Sons, Inc. Head Neck 19: 188–193, 1997.